Sunday, February 9, 2014

One Step Forward, Two Steps Back

It's Sunday and my mother remains in the hospital.  It has been another case of one step forward and two back.  The dementia adds a whole new dimension to it.  Every other day has been a bad day, which means progress is very slow.

She fell on Monday and on Wednesday she still could not move out of bed, even coughing would make her grab her side.  Before I went over on Wednesday, I called Amedisys, the home health people, and asked if they could send someone over to evaluate her.  Micheal, the therapist who has worked with her several times, came over, which was a great relief.  It didn't take him long to determine that she needed to be sent out again, so off we go to the ER again.  I Mae sure to get there before Mama in order to see that a lot of "efficient" but invasive procedues (that agitate people with dementia) were not done.  One our previous visit they had put an IV line in that was never used.  She will tolerate a little of this, but at some point she begins pulling them out....which she would never do if she were herself.  A different physician ran a few tests and x-rays again and, sure enough, the hip was broken.  She went into surgery around 6PM.  I went home and took care of the kitties so I could be back by the time she got to a room.  

She got through the surgery fine and even the next day, though movement remained doubt aggravated by two days of I attention and pain!  The second day she was either combative and abusive or asleep, so no PT was done and everything was difficult.  The doctor said that the second and/or third days could be worse than the first, and that proved to be true.  The third day, Friday, she was sitting up when I got there and had a good day, eating well and moving (with help) from the bed to the pot and to the chair.  She worked with the therapist and by late in the day could make those transitions without screams of pain.  But late in the day she began to become agitated, so I kept a low profile (as I can do no right during those times) and left once she had dinner and was moved to the bed.  

When I came in this morning, I saw the nurse in the hallway and asked how she was through the night, to be told that she had been moved to the cardiac wing.  She had become agitated and had an irregular, rapid heartbeat, with her BP dropping very low. She was surprised that I had not been called, but I learned that this had begun around 6:30AM and I guess there had not been time to call once things were somewhat under control.  In the process of the move, she had cut her finger, which had bleed a lot.  Because of her striking out at nurses and attendants, she was restrained and still agitated, though she settled bit after I arrive.  I'm damned if I do and damned if I don't.  I'm sure part of her agitation is that I go home at night, but she also gets agitated when I come in the morning.  This morning she was mildly agitated and resistant to anything I suggested.  She refused to eat breakfast or have milk or coffee, both of which she loves.  So, I asked her several times and when she refused, I put things away, sat down and asked to to let me know if she wanted anything.  That is usually the best thing until she eventually vents it all or forgets about it.  By the time the nurses came in a few times, she seemed pretty well over it. Around 10:15AM she was taken to the OR to suture the finger cut.  It's now 12:30 and they are just bringing her back to the room.  We'll see where things go from here.

So, I'm pooped.  Every morning it becomes harder to get up and takes longer to get going.  It is mostly mental exhaustion and physical stagnation, but it's harder that work!  It her heart stabilizes over the next day, I hope she will be transferred to a nursing facility and maybe that setting will be less stressful.    Since I didn't receive a call about the heart situation, I was totally shocked when I arrived this morning, but all he ups and downs of this whole process removes some of the sting. You just learn that it is the nature of things.